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The Difference Between Doctors & Nurses (Explained By A Doctor)

The Difference Between Doctors & Nurses (Explained By A Doctor)

Updated on: December 3, 2023
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Written By Dr Ollie

Every article is fact-checked by a medical professional. However, inaccuracies may still persist.

Doctors and nurses both care for patients, generally in a hospital, and try to improve the quality of patients’ lives by treating disease.

Because of how closely aligned the two profession’s goals are, there are a lot of similarities between them. But, what’s the difference between doctors and nurses?

Broadly speaking, doctors direct care whereas nurses will actually deliver that care. Doctors set the overall direction for a patient’s care, including what investigations should be performed and what treatments should be trialled, whereas nurses are actually hands-on caring for the patient.

Admittedly, because of the huge amount of overlap in their roles, it’s not always easy to tell the difference between doctors and nurses.

In this article, however, I’m going to break down exactly what sets the two professions apart, using my experience of having worked as a doctor alongside hundreds of nurses, to delve into the nuanced differences across five different domains.

The Difference Between…DoctorsNurses
Job RoleSet the direction for patient’s careMore hands-on practical delivery of care
Average Salary£76,000£33,000
Training Length5 years3 years
Career ProgressionRobust pathways to top positionsLimited and often more management roles
ResponsibilityUltimately responsible for patient careResponsible just for personal actions
Summary of the differences between doctors and nurses

The Difference Between What Doctors And Nurses Do

Doctors and nurses can both work across a huge variety of settings, in a huge variety of capacities, but to keep things simple let’s consider a patient on a ward in a hospital.

Let’s say that patient is an eighty-year-old female and she presented the night before to A&E complaining of abdominal pain.

It’s the doctor’s role to speak to the patient and find out what’s going on. The doctor will then examine the patient, in this case that will mean having a feel of her tummy, and then come up with a plan.

This plan might include a number of different investigations that need doing (such as scans or blood tests) or prescribing some medications for the patient.

It would then be the nurse who physically gives the patient these medications, such as some strong painkillers or anti-sickness drugs, and the nurse who would make sure the patient is ready to go for any scans the doctor might have ordered when the time comes.

Nurses are generally a patient’s first point of contact and deliver hands-on care on a ward. If this elderly lady is on the ward for a couple of days, she might need help washing, feeding herself, going to the toilet and sorting out who’s going to feed her cat at home.

It would be the nurse, with the help of some healthcare assistants, who’d manage all of this direct care.

A nurse taking a little boy’s temperature

The doctor’s job is to order the correct tests, in order to arrive at the correct diagnosis, so that the best treatment can be initiated and the patient can get better as soon as possible. Having worked as a junior doctor, I can tell you this is definitely easier said than done!

Doctors generally see every patient under their care at least once a day, so that they can review how the patient is doing, the results of any tests that have been ordered, and decide on a direction for the patient’s treatment moving forward.

Medicine is a vast field, with doctors and nurses working in every shape and form across it, so there are always going to be exceptions to any rule of what a doctor does vs a nurse.

However, hopefully this simple microcosm will have given you a flavour of how their job roles are distinguishable in a hospital.

Nurse Vs Doctor Salary In The UK

Although you won’t find many doctors or nurses who are just in it for the money, if you’re trying to decide between the two professions you may be interested in how a doctor’s salary compares to a nurse’s.

A doctor in the UK can expect to earn an average of £76,000 per year while the average salary for a nurse is £33,000. Both professions can work in the NHS or privately, but doctors broadly have an increased potential for developing a lucrative private practice.

Pay for both doctors and nurses in the NHS broadly reflects the level of seniority of that practitioner. A doctor’s pay progresses as they climb the ladder towards consultancy and a nurse’s pay will jump up each time they move up a band.

Immediately after graduating£29,000£26,000
After 5 years£51,000£39,000
After 10 years£85,000£47,000
After 20 years£101,000£66,000
Estimates of NHS base pay for doctors vs nurses

You will have to take the figures I’ve included in the table with a pinch of salt. There are a huge number of factors that can influence where someone’s career will be twenty years after graduating and how much money they’ll be earning.

The salaries also only represent the NHS base pay for each level. Both doctors and nurses have the option to take on extra shifts for extra money, or work privately alongside their NHS work.

I would say doctors, particularly surgeons, do however have more opportunity to develop a large and lucrative private practice. Surgeons working privately, alongside their NHS role, can easily double their take-home salary, if not more.

Nurses on the other hand are generally limited to taking on extra shifts for a bank agency. Although maybe not as glamorous as having your own private surgical practice, experienced nurses can earn over £50 per hour for these extra shifts which quickly adds up if they’re doing them regularly.

How Does Training For Doctors And Nurses Differ?

Training for both doctors and nurses is a long old road of learning about scientific theory, clinical reasoning and practical skills.

While both pathways produce clinically competent professionals as the end result, there are some pretty big differences between the two different routes.

To become a doctor in the UK, you’re going to have to go to medical school. That’s generally 4-6 years at university, depending on the course, learning everything you need to know to start work as a junior doctor.

Medical school is notoriously difficult to get into- there are stringent entry requirements in addition to high competition ratios. And once you’re actually there you’re far from being out of the woods.

Medical school is in no way an attendance course– it demands a lot of hard work and dedication from every student. However, at the end of it all you have the satisfaction of graduating as a newly minted doctor.

Studying nursing at university is considerably quicker at only three years. But don’t mistake that for making it a walk in the park.

Nursing degrees are still a lot of hard work, with an apprenticeship style model used for the latter stages of the course. These placements are almost like being in full-time work as a nursing student except you aren’t getting paid!

One benefit of studying nursing at university rather than medicine is that you’ll have a much greater choice of where you want to study- there are 129 different institutions where you can study nursing compared to only 34 medical schools in the UK. The academic entry requirements are also lower which can give you a lot more flexibility with A-level results.

Undergraduate TrainingDoctorsNurses
Course Length5 years3 years
Entry RequirementsAAA – A*AABCC – BBB
Cost Per Year£9250£9250
Number Of Universities Offering Course34129

Doctors Vs Nurses Career Progression

In many ways, the day you step out of university as a newly qualified doctor or nurse is the day you start your training as a healthcare professional.

For doctors, there’s a long ladder of foundation years, core training, and then years as a registrar until you reach the top position of consultant. How long it takes to become a fully qualified doctor depends on both the specialty and the exact route a doctor takes to get there.

Throughout that journey, you’ll have postgraduate exams sprinkled in that are even worse than the ones at medical school!

Nurses’ postgraduate progression on the other hand follows the NHS banding system:

  • Band 5 – newly qualified nurse
  • Band 6 – nursing specialist or senior nurse
  • Band 7 – advanced nurse/nurse practitioner
  • Band 8 – modern matron or chief nurse

You start out at band 5 and then over time, as you gain experience and seniority, you work your way up the bands.

A nurse delivering treatment to a patient

Towards the top end, nurses start to take on more of a management role rather than working in a purely clinical capacity. A modern matron will be in charge of looking after a large team of staff as well as still carrying out a variety of nursing duties.

I think this is probably the biggest difference between the career progression of doctors vs nurses. As a doctor, you can follow robust training pathways that will take you from a foundation year 1 doctor all the way up to a consultant surgeon- who still spends the vast majority of their day operating and seeing patients.

This is in contrast to nurses, who will generally be forced to take on more of a management capacity the higher they climb in the NHS ecosystem. If nurses don’t want to lose their clinical focus then an alternative pathway is for them to become a nurse practitioner…

What’s The Difference Between Doctors And Nurse Practitioners?

Nurse practitioners are essentially very experienced and qualified nurses, who have taken more of a step toward clinical assessment rather than management as they progressed through their careers.

They’re mid-level practitioners and so operate at roughly the level of a doctor who’s been working for 3-5 years. Nurse practitioners blur the lines between doctors and nurses as they can expand their skillset to include pretty much everything a junior doctor might do. They can:

  • Take histories from and examine patients
  • Arrive at reasoned diagnoses
  • Take blood tests and order x-rays
  • Prescribe medication including controlled drugs
  • Work independently without supervision

The real differences then between doctors and nurse practitioners then come from how each arrived at their current position and what options they have for progression from that position.

To become a mid-level practitioner, a doctor will have gone to medical school and then completed the foundation training program- which is two years of working as a junior doctor across a range of different departments in the hospital.

To become a nurse practitioner, a nurse will have had to qualify as a nurse, work as a nurse for at least 5-7 years, pursue a master’s degree and take all the relevant prescribing qualifications.

As you can imagine, this is a longer and more convoluted path compared to medical school and a couple of years of working as a doctor.

Because nurses will generally reach the position of nurse practitioner later on in their career, there aren’t always clear promotion pathways from the position. Nurse practitioner is a relatively senior position in itself so nurses may spend the rest of their career just practicing in this capacity.

Doctors on the other hand will generally be aiming to progress from a mid-level practitioner to a higher-level practitioner or senior doctor. By subscribing to the relevant training pathways, doctors are able to progress relatively easily as long as they complete all the required training objectives.

Final Thoughts

Although doctors and nurses may superficially seem incredibly similar, in almost every respect there’s a slight difference between the two professions.

It’s almost like comparing apples to oranges- nurses aren’t just second-rate doctors and doctors aren’t just overqualified and overpaid nurses. They both have distinct roles in the healthcare setting and work synergistically to deliver the best possible care to patients.

If you are considering applying to university for medicine, nursing, or even both, I think the best way to truly understand how they differ is to get some work experience where you can actually watch both doctors and nurses work together.

This will be invaluable to you if you’re asked at interview why you want to be either a doctor or nurse compared to the other.

And if you’re on the fence about which you should apply to, in my entirely unbiased opinion as a doctor, I’d suggest medicine would be the perfect fit for you!

About the author
After studying medicine at the University of Leicester, Dr Ollie now works as a junior doctor in London. His interests include medical education and expedition medicine, as well as having a strong belief in the importance of widening access to medicine.